Provider Demographics
NPI:1194247734
Name:LEON C. WINTERS LCSW, LLC
Entity type:Organization
Organization Name:LEON C. WINTERS LCSW, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LEON
Authorized Official - Middle Name:C
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:337-962-1987
Mailing Address - Street 1:1304 BERTRAND DR STE B3
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-9102
Mailing Address - Country:US
Mailing Address - Phone:337-962-1987
Mailing Address - Fax:844-364-1683
Practice Address - Street 1:1304 BERTRAND DR STE B3
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-9102
Practice Address - Country:US
Practice Address - Phone:337-962-1987
Practice Address - Fax:844-364-1683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty